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					NAME                                                                  CONFIDENTIAL
DATE                                                                 Version 3.0 3/31/06
Page 1 of 4

                                  Provider Contract
 NYU School of Medicine Woodhull and Cumberland Affiliation Agreement
As an attending physician at Woodhull and Cumberland in the Department of Medicine your
responsibilities are as follows:

General Responsibilities

You are responsible for the efficient delivery of the Patient Care Services assigned to you by
your Chief of Service at Woodhull and Cumberland (or Medical Director of Woodhull and
Cumberland if letter is for Chief). Such efficient delivery will include attention paid to such
matters as length of stay, utilization management and patient satisfaction. You will also be
responsible for:

   •   The performance of teaching services assigned by your Chief of Service (or Medical
       Director of Woodhull and Cumberland if applicable);
   •   Supervision of residents and medical students;
   •   Compliance with applicable Regulations;
   •   Compliance with performance indicators once finalized;
   •   Participation in performance improvement activities including development and/or
       compliance with clinical pathways once finalized;
   •   The professional conduct of approved research (if applicable);
   •   Attendance at committee and departmental meetings, as required;
   •   Notifying and discharging patients in a timely fashion, as applicable;
   •   Timely, accurate and legible completion of Medical Records (see below);
   •   Timely completion of responses to preliminary denials of reimbursement from Third
       Party Payer reimbursement sources, as applicable;
   •   Full cooperation with the credentialing and reappointment process;
   •   See all outpatients in a timely fashion; i.e., as closely as possible to the patient’s
       appointment time (subject to your responsibilities to other patients) or, in the case of
       unscheduled patients, as soon as practicable;
   •   Becoming and/or maintaining board certification;
   •   Abide by the Health and Hospital Corporation (HHC) code of ethics (See
       http://www.med.nyu.edu/affiliationoffice/dohmanual/);
   •   Understanding and abiding by the HHC Patient Rights guideline (See
       http://www.med.nyu.edu/affiliationoffice/dohmanual/);
   •   Cooperate with any audit as requested by Woodhull and Cumberland or NYU’s
       Affiliation Office.

   You will be regularly evaluated on your compliance with the above by the NYU Affiliation
   Office and your Chief of Service (or Medical Director of Woodhull and Cumberland if
   applicable).

Time Keeping
NAME                                                                     CONFIDENTIAL
DATE                                                                    Version 3.0 3/31/06
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   •   You understand that you are responsible for maintaining accurate manual or online
       records of your time and/or complying with the timekeeping methodology set by your
       department and approved by the NYU Affiliation Office; This time must accurately
       reflect the time/FTE (full time effort) for which you are paid by the Affiliation Contract;
   •   All time sheets must be signed by you and reviewed and signed by your Chief of Service;
   •   You are responsible for notifying your Chief of Service (or Medical Director of
       Woodhull and Cumberland if applicable) on a yearly basis of all planned vacations and
       CME;
   •   You are responsible for notifying your Chief of Service (or Medical Director of
       Woodhull and Cumberland if applicable) of all upcoming absences from clinic in a
       timely enough fashion so that coverage may be obtained;
   •   All time sheets are subject to audit.

Transfer and Referral of Patients

You will not recommend transfer, transfer and/or refer patients to facilities that are not operated
by HHC except when:

   •   The required services are not available at Woodhull and Cumberland;
   •   A Third Party Reimbursement plan does not authorize the provision of a necessary
       service at Woodhull and Cumberland;
   •   The patient independently (i.e. without the suggesting or urging of you or another)
       requests a transfer or referral.

Such transfers and referrals, where required services are unavailable, will be to other HHC
facilities whenever possible.

Documentation of Patient Care Services

To ensure proper billing and reimbursement from Third Party Reimbursement payers, you will:

   •   Take a coding and documentation course, coordinated by Woodhull and Cumberland,
       within three (3) months after commencement of credentialing at Woodhull and
       Cumberland;
   •   Complete and return all hospital coding sheets, and/or to the extent coding for billing
       purposes is captured on-line, enter those CPT-4 and ICD-9 codes which fully and
       accurately describe the services into Misys for all clinical services performed which such
       coding sheets are required;
   •   Sign and legibly print or stamp your name and MDID on all written documents;
   •   Date and time all progress, procedure, and consult notes;
   •   Notate on the chart if the patient’s primary language is not English and delineate
       interpretive services/devices used to assist in communication with the patient (inpatients
       and outpatients);
   •   Immediately co-sign all medical student documentation;
NAME                                                                    CONFIDENTIAL
DATE                                                                   Version 3.0 3/31/06
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   •   Document all patient consent forms according to hospital policy;
   •   Verify all outpatient visits within 24 hours on Misys if you see or precept outpatient
       visits;
   •   Complete all inpatient medical records within 30 days, as applicable;
   •   Dictate all operative reports within 24 hours, if applicable;
   •   Complete and sign History & Physicals within twenty-four hours of admission if you are
       the admitting Attending;
   •   Write Attending notes every other day and/or every time there is a significant change in
       the patient’s condition;
   •   Assure that each inpatient medical record contains an assessment and admitting note that
       details the medical conditions and relevant medical and social history of the patient, or
       details the social conditions to which the patient would otherwise return; and expressly
       indicates that hospital admission is necessary in light of either or both of these factors.

Additional information on Documentation and Coding                      may     be    found    at:
http://www.med.nyu.edu/affiliations/resources/documentation.html.


Mandated Training, Surveys, and Other Online Programs

You will complete all training programs mandated by the Corporation. These programs include,
but are not limited to:
    • HIPAA (this may consist of multiple modules offered at different times):
        http://hipaacbt.nychhc.org. By accessing this web site you will automatically be able to
        see what modules you have completed and what modules are outstanding;
    • Fraud Awareness & Compliance (http://compliancecbt.nychhc.org) which is designed to
        ensure compliance with the requirements of Compliance Regulations, including, without
        limitation, adherence to proper coding and billing procedures;
    • Clinic-legal Correlations (http://nychhc.elmexchange.com);
    • Department of Health Mandated In-service (Acknowledgement of receipt of training
        material or attendance at Health Mandates Fairs offered twice a year at Woodhull and
        Cumberland);
    • (http://www.med.nyu.edu/affiliationoffice/dohmanual/);
    • You will be responsible for completing all GME Attending Time Surveys within the
        designated time period (http://tools.med.nyu.edu/mdtimesurvey/);
    • You will complete cultural competency training within the specified time period;
    • You will participate in bioterrorism training offered yearly.

You understand that these training programs and surveys must be completed on-line if required,
and your continued medical staff privileges may be contingent on completing these training
modules within the specified time frames.

More information on training and surveys may be found by logging on to:
http://www.med.nyu.edu/affiliations/training/training.html.
NAME                                                                      CONFIDENTIAL
DATE                                                                     Version 3.0 3/31/06
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Malpractice and Indemnification

In accordance with HHC policies, once credentialed at Woodhull and Cumberland you are
indemnified for Malpractice. Defendants in lawsuits which arise from service at HHC facilities
are represented by the New York City Law Department and its retained private law firms. Log
on to http://www.med.nyu.edu/affiliations/personnel/malpractice.html for more information and
documents related to malpractice at Woodhull and Cumberland. Your responsibilities, in
addition to those outlined in the links, are as follows:
    • You understand that you are not covered for defense and indemnification for Acts or
        omissions to act occurring anywhere other than at Woodhull and Cumberland and its
        satellites and other facilities where the Corporation has approved the provision of
        Contract Services; or during transfer of a patient;
    • You understand that if you receive any summons or notice of claim, these must be
        promptly forwarded to the Corporation;
    • You should keep your Chief of Service (of Medical Director if applicable) and/or the
        NYU Affiliation Office apprised of any concerns you have regarding the handling of
        your defense as early in the process as possible. While you should not reveal specific
        medical facts of the case to anyone other than those in Risk Management, the attorneys
        and their designees, it is important that the School is made aware of any concerns you
        have regarding the handling of your case;
    • You must provide all information and cooperation requested by the Corporation and the
        City to investigate, adjust, settle or defend such claim, action or proceeding and must not,
        directly or through an attorney or agent, take any action constituting a waiver of a legal
        defense available in response to such claim, action or proceeding.

Gifts and Grants

You understand that prior to applying for any funds from any source for the support of research,
educational, service and scientific activities to be carried out at Woodhull and Cumberland and
its’ satellites and/or to involve Affiliate or HHC paid personnel, you must notify both Woodhull
and Cumberland and the NYU Affiliation Office prior to any such application.

See also http://www.med.nyu.edu/affiliations/resources/Woodhull and Cumberland.html for
additional information related to grants and research at Woodhull and Cumberland.

				
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